Clinical Outcomes after Isolated Medial Patellofemoral Ligament Reconstruction for Patellar Instability
نویسندگان
چکیده
BACKGROUND Medial patellofemoral ligament (MPFL) reconstruction has become one of the most common and widely used procedures to regain stability among patients with recurrent lateral patellar dislocation. While recent studies demonstrated low recurrence rates, improved patient-reported outcome measures, and a high rate of return to sports, limited literature explored its effectiveness as an isolated intervention in the context of trochlear dysplasia. PURPOSE To determine the efficacy of isolated MPFL reconstruction in treating patellar instability in the setting of trochlear dysplasia. STUDY DESIGN Case series; Level of evidence, 4. METHODS This was a retrospective review of consecutive patients who underwent uni- or bilateral medial patellofemoral ligament reconstruction for patellofemoral instability with a minimum 2-year follow-up. No osteotomies were included. Pre- and postoperative assessment included ligamentous laxity, patellar crepitus, tilt, translation, apprehension, and radiographic features, including tibial tubercle-trochlear groove (TT-TG) distance, Dejour classification, and Caton-Deschamps index. RESULTS A total of 121 MPFL reconstructions were included. Mean age at surgery was 23.8 years, and 4.4 dislocation events occurred before surgery. Mean follow-up was 44 months; 76% of patients were female. Mean preoperative TT-TG ratio was 13.5, and mean Caton-Deschamps ratio was 1.2; 92% of patients had Dejour B, C, or D trochlear dysplasia. Kujala score improved from 55.0 preoperatively to 90.0 ( P < .001). Almost all patients (94.5%) were able to return to sports at 1 year, with 74% returning to the same or higher level of play. Only 3 patients reported a postoperative dislocation or subluxation event. DISCUSSION For patients without significantly elevated TT-TG distances or significant patella alta, isolated MPFL reconstruction provides a safe and effective treatment for patellofemoral instability, despite the presence of trochlear dysplasia. Most patients are able to return to sports by 1 year postoperatively at the same or higher level of play.
منابع مشابه
Outcomes After Isolated Medial Patellofemoral Ligament Reconstruction for the Treatment of Recurrent Lateral Patellar Dislocations: A Systematic Review and Meta-analysis.
BACKGROUND A patellar dislocation is a common knee injury in the young, athletic patient population. Recent trends indicate that the use of long-term nonoperative treatment is decreasing, and surgical intervention is more commonly recommended for those patients who fail initial nonoperative management with recurrent patellar dislocations. Medial patellofemoral ligament (MPFL) reconstruction has...
متن کاملGuidelines for medial patellofemoral ligament reconstruction in chronic lateral patellar instability.
The standard surgical approach for chronic lateral patellar instability with at least two documented patellar dislocations is to stabilize the patella by using an anatomic medial patellofemoral ligament reconstruction with a mini-open technique and a graft that is stronger than the native ligament to compensate for the uncorrected predisposing factors underlying patellar instability. Even thoug...
متن کاملBiomechanical Comparison of Medial Patellofemoral Ligament Reconstuction and Distal Realignment for Patellar Instability
In recent years, the medial patellofemoral ligament (MPFL) has been considered as the primary restraint of the medial patellar stabilizers [1]. Clinical reports have revealed that MPFL injury occurs in almost all patients with traumatic patellar dislocation, and attention has been focused on the repair and reconstruction of the MPFL in recurrent patellar dislocation and patellar subluxation [2]...
متن کاملMPFL reconstruction femoral canal MRI
Feb 7, 2017. The center of the femoral tunnel (T) from the MPFL reconstruction was. .. Anatomy and biomechanics of the medial patellofemoral ligament. in patients with acute patellar dislocations. Anatomy. The medial retinacular. 3Department of Surgery, Division of Orthopedics, Duke University Medical Center , Durham, NC in layer two are medial patellofemoral ligament (MPFL), superficial. .. mu...
متن کاملReconstruction of the medial patellofemoral ligament for patellar instability using an autologous gracilis tendon graft.
Patellofemoral dislocations are common. In cases with recurrence or residual instability, surgical intervention is usually considered. Numerous treatment protocols have been used in the past to treat patellofemoral instability secondary to patella dislocation. Reconstruction of the medial patellofemoral ligament is one of the possible options, since it was acknowledged to have a major medial st...
متن کامل